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DocuSign Envelope ID: E4F3CD63-A309-4179-BF53-F3F8F279F3E8 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name:The Community Empowerment Fund.Party/Vendor Contact Person:ari rosenberg Contact Phone: <br /> 919-808-9660 Party/Vendor Address: 208 N. Columbia Street, Suite 100 City Chapel Hill State: NC Zip: 27514 <br /> Department: Finance & Administrative Services Amount: $50,000 Purpose: FY 2020-21 Outside Agency/Iluman <br /> Services Performance Agreement Budget Code(s): 10495050-710015 Vendor#61695 (N/A if new vendor)Vendor is a <br /> BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date <br /> 7/l/2020 Approved by Board Yes®Nor-1 Agenda Date: 6/16/2020 <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> ... Date: <br /> 1/21/2021 <br /> Department Director's Sinature `� G �U� A,�D42B075CF42M7 Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned <br /> ""by: <br /> ''ll� <br /> Office of the Risk Management Officer auSa rbvvu,TTb Date:112112021 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer 0..&°n Date:1/21/2021 <br /> 7NE5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the CountyAttorne n e ,� 1/21/2021 <br /> Il�n In 1_ IVI p�f_ I ACfA Date: <br /> 079MD525COWB... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion @ sin erg sollP_oran eg countync. oovv <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> The Community Empowerment Fund <br /> Orange County Outside Agency Performance Agreement Page 6 of 9 <br /> Rev. 1121 <br />